To treat an enlarged prostate, some people use herbs, from flaxseed to stinging nettle to prickly pear cactus. At typical doses, experts say that most plant extracts are probably safe for BPH, or benign prostatic hyperplasia. But do they work?
Some supplements may help. Others -- including the most popular, saw palmetto -- might not. And a few, including zinc, may actually put you at risk for getting BPH.
The Benign Prostate Hyperplasia (BPH) Symptom Score Index can help your doctor understand how severe enlarged prostate symptoms are.
If your total score is less than seven, your symptoms are considered mild. Higher scores indicate more severe symptoms. Your doctor can discuss your scores with you -- and what they indicate about your need for treatment.
Use the following point scale to answer each of the questions. Total the score from all the questions.
0 = Not at all
3 = About...
Beta-sitosterols may help your urine flow better and leave less in your bladder. They may be worth a try, especially if you have high cholesterol. Beta-sitosterols, a plant version of cholesterol, are also used to lower cholesterol and are in some cholesterol-lowering margarines. Try 60 to 130 milligrams a day.
Pygeum, also known as African plum extract, could cut down on the times you have to get up to urinate at night and can improve urine flow. It may not work as well as standard treatments like alpha-blockers, though. Try 75 to 200 milligrams a day. Experts encourage using only sustainably harvested pygeum.
Supplements That May Help
Two studies showed that rye grass pollen extract may relax the muscles of the tube that urine flows through and help bladder muscles contract. You may have less dribbling after urinating and need to get up less often at night to urinate. In one study, it also appeared to shrink prostate size. If you want to try it, it's probably safe for up to 6 months.
Some older research suggests that Harzol, an extract of African wild potato (South African star grass), may ease urinary symptoms. That's probably because it's high in beta-sitosterols. But it may also lower blood sugar levels. So if you have diabetes, you may want to skip products with this plant. And if you do try it, watch your blood sugar closely.
The Latest Science on Saw Palmetto
Extract of the berries from this small palm tree is a favorite remedy for BPH, but studies are mixed on how well it works. Early studies showed that taking 320 milligrams a day could ease urinary symptoms. Some even showed that it worked as well as the BPH drug finasteride.
But newer and larger studies have shown that saw palmetto works no better than a placebo -- even at higher doses. And it doesn't shrink your prostate gland, just its lining.
The benefits of saw palmetto seem to be modest at best. If you want to try it, look for a fat-soluble extract that contains 85% to 95% fatty acids and sterols.
Tips for Taking Supplements
Before you take any natural remedy, talk to your doctor. They can interact with drugs you're already taking or with other herbs and supplements.
The FDA regulates dietary supplements; however, it treats them like foods rather than medications. Unlike drug manufacturers, the makers of supplements don’t have to show their products are safe or effective before selling them on the market.
It's not always certain what's in supplements. So try a product with one ingredient only -- just pygeum, for example. You don't have to buy a brand that costs a lot. But if a standardized extract was studied in human trials, start with that one.
If your doctor says it's OK, give it a month or two. If your symptoms don't get better, try another brand or a different dose for a month or two. If that doesn't help, you could switch again. But if that doesn't help, give up on that supplement.
Herbal remedies or supplements may not help your symptoms. You may get more relief with a BPH drug.